Atrial fibrillation diagnosis tied to memory decline risk

Examining dementia in 4.3 million individuals with atrial fibrillation.

A new study involving 4.3 million people in the UK found that those diagnosed with atrial fibrillation (AF) had a 45% higher risk of mild cognitive impairment (MCI). MCI is an early stage of cognitive decline and can sometimes indicate the early onset of dementia-related conditions. The study suggests that factors like cardiovascular risks and other health issues may contribute to the progression from MCI to dementia in these individuals.

This research sheds light on the connection between MCI and AF diagnosis in the UK, which had not been thoroughly explored before.

Rui Providencia, MD, Ph.D., Full Professor at the Institute of Health Informatics Research at University College London and the study’s senior author, said, “Our study showed that AF was associated with a 45% increase in the risk of MCI and that cardiovascular risk factors and multi-comorbidity appear to associate with this outcome.”

Researchers used the health records of 4.3 million individuals in the UK to study the risk of mild cognitive impairment (MCI) following a diagnosis of atrial fibrillation (AF). They identified 233,833 individuals with AF and 233,747 without AF.

The study found that after an AF diagnosis, there was a 45% higher risk of MCI. Other factors linked to a greater MCI risk included older age, female gender, socioeconomic status, a history of depression, stroke, and having multiple health conditions. However, these factors did not change the connection between AF and MCI. Among people aged over 74, AF and MCI were often diagnosed when multiple health conditions like diabetes, depression, high cholesterol, and peripheral artery disease were present.

Interestingly, patients with AF who received treatment with digoxin didn’t show an increased risk of MCI. Conversely, the risk of MCI was higher in AF patients who didn’t receive oral anticoagulant therapy and those who received amiodarone treatment. Patients with AF who were treated with oral anticoagulants and amiodarone treatment did not face a higher risk of MCI.

During the study, 1,117 individuals were diagnosed with dementia after having mild cognitive impairment (MCI). Those with MCI who also had atrial fibrillation (AF) were at a higher risk of developing dementia. The risk of dementia was also associated with factors like gender, asthma, smoking, chronic kidney disease, and having multiple health conditions.

The research suggests that cardiovascular risk factors and the presence of various health issues may influence the progression from MCI to dementia. To potentially prevent cognitive decline and the development of dementia, the researchers propose integrated care for AF, which includes managing comorbidities alongside anticoagulation treatment. Further research, in the form of a clinical trial, is needed to explore this idea more deeply.

This study underscores the potential association between AF diagnosis and an elevated risk of memory decline. Understanding this link offers opportunities for more comprehensive and integrated care strategies to address cognitive deterioration in individuals with AF, potentially reducing the risk of dementia. Further exploration of these findings through a clinical trial is recommended for a deeper understanding of this complex relationship.

Journal reference:

Sheng-Chia Chung Ph.D., Martin Rossor MD, et al., Cognitive Impairment and Dementia in Atrial Fibrillation: A Population Study of 4.3 Million Individuals. JACC: Advances. DOI: 10.1016/j.jacadv.2023.100655.

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